The ulnar collateral ligament (UCL) runs along the outside of the elbow and is needed to keep the elbow stable and functioning well. However, injury is common in this ligament particularly during throwing sports such as javelin, football, and baseball. In fact, the name of the treatment for this issue is often referred to as “Tommy John surgery,” after the Los Angeles Dodgers pitcher who was the first baseball player to undergo the surgery and return to a baseball career. The surgery was so successful that he played for 13 more years, retiring after 26 seasons of baseball.
Since then, the surgery has been successful in thousands of athletes. The tearing of the UCL is often a chronic injury, though it can also be ruptured by a fall on an outstretched hand or a similar trauma.
Surgery is often recommended for athletes to help them fully recover and continue in sports. During the surgery, the ligament is reconstructed from another ligament in the patient’s body, often from the forearm, hamstring, or knee. Often, the surgeon will use part of the palmaris longus tendon, which is located on the inside of the forearm.
The surgeon threads the new ligament through holes drilled in a figure-8 style for proper tension in the ligament.
After the surgery, the patient spends 1-2 weeks with an immobilized elbow. After that, the patient begins physical therapy with shoulder range of motion exercises before it progresses to the elbow. Recovery to full strength and function can take up to a year for the average athlete. However, many athletes report they can play better than before.